北京冬季奥林匹克运动会运动员手术的麻醉管理

Anesthesia management of athletes’operation in Beijing Olympic Winter Games

2022年2月4日,第24届冬季奥林匹克运动会(简称冬奥会)在北京顺利举行。据文献报道[1],近年冬奥会运动员的受伤率高达10%~14%。结合新型冠状病毒肺炎(corona virus disease 2019,COVID-19,简称新冠)的疫情防控背景,本届北京冬奥会对医疗保障工作提出了更高的要求,面临更严峻的挑战。为了能更好地优化麻醉管理,我们总结了新冠疫情下冬奥会运动员的围术期处理经过、麻醉管理及安全防护策略,以及围术期药物对运动员的潜在影响。

According to literature reports, the injury rate of the athletes in Olympic Winter Games recent years was as high as 10%-14%. Combined with the background of corona virus disease 2019(COVID-19), the medical insurance work of the 24 th Olympic Winter Games held in Beijing had put forward more complicated requirements and more severe challenges. In order to better optimize anesthesia management, this article summarized the perioperative treatment of athletes in Olympic Winter Games, the safety protection strategy of medical staff under general anesthesia, and the potential impact of peri-operative drugs on athletes. Anesthesiologists, as the core members of the rescue team, should be familiar with the particularity of operative anesthesia of athletes, sum up relevant experience to ensure the safety of perioperative patients. So all kinds of technical measures should be taken in the process of operation to minimize the indoor pollution caused by the patient’s cough. For example, all the patients should wear N95 masks from the ward to the operating room, and after the operation, wear the N95 masks back to the ward. Although the International Olympic Committee had banned more than 200 drugs for participants and athletes who had to strictly follow International Olympic Committee requirements during anesthesia, the athletes were no longer participating in this Olympic Winter Games, so opioids(sufentanil and remifentanil) and glucocorticoid(dexamethasone) could be used according to the actual needs of surgery and anesthesia. Five athletes in Yanqing competition area underwent surgical anesthesia in Peking University Third Hospital Yanqing Hospital. All the five patients received general anesthesia, of whom four underwent orthopaedic surgery and one underwent laparoscopic cholecystectomy. General anesthesia with laryngeal mask airway was the first choice in the five patients. And the pain after orthopaedic surgery was severe and nerve block technique could effectively relieve the pain after surgery. Three patients received ultrasound-guided nerve block analgesia, the postoperative analgesia lasted 36 h. After the operation, non-steroidal anti-inflammatory drug(NSAID) was infused intravenously in the ward and all the patients recovered uneventfully. As the core member of the trauma rescue team, anesthesiologists should be familiar with the particularity of the athletes’ surgical anesthesia, do a good job in medical security, and summarize relevant experience to ensure the life safety of the perioperative patients.